APPLICANT'S ABSTRACT: This application is in response to NIAAA Program Announcement 99-043 "Behavioral Science Track Awards for Rapid Transition - NIAAA." This two-year study will develop and pilot test a motivational enhancement-based HIV risk reduction intervention for low income, urban women in treatment for alcohol use disorders. This population is at increased risk for HIV infection but has not benefited from research designed to develop effective HIV prevention interventions. The proposed study will be conducted in two phases. In phase 1, measures will be pilot tested and focus groups will be conducted with 30 women, all receiving services at inner-city alcohol treatment facilities, regarding their health, social networks, sexual behavior, and other drug use. This information will be used to tailor the content procedures of the intervention designed to reduce HIV-risk behavior. In Phase 2, 80 low-income urban women in treatment for an alcohol use disorder and who have engaged in sexual HIV risk behavior over the past 90 days will be randomly assigned to one of two conditions: Alcohol treatment as usual (n=40), or alcohol treatment as usual plus an 8-session HIV-risk reduction intervention (n=40) based on the Information Motivation Behavioral Skills (IMB) model of HIV-preventive behavior, using one-on-one motivational interviewing and small-group skills training activities. Assessments will occur at baseline, post-intervention, and at a six-month follow-up. The efficacy of the HIV intervention in reducing the frequency of unprotected sexual intercourse and increasing the percentage of protected sexual intercourse from baseline assessment to 6-month follow-up will be determined using repeated measures analysis of variance (ANOVA) to test for a significant group x time interaction. Participants receiving both alcohol treatment and the HIV-risk reduction intervention are expected to exhibit the greatest reduction in sexual risk behavior and increases in HIV preventive behavior. Finally, the efficacy of the HIV intervention in producing improvements in the IMB model-based psychological antecedents of HIV-risk and preventive behavior, as assessed at baseline, post-intervention, and 6-month follow up, will be evaluated using repeated measures multi variate analysis of variance (MANOVA). This will be one of the first randomized studies of the additive effects of alcohol treatment and an HIV-risk reduction intervention among people with alcohol use disorders. The intervention will have the added benefit of being tailored specifically to the prevention needs of low income, urban women who abuse alcohol, a group at increasing risk of HIV infection through heterosexual activity. Further, this study will likely identify key issues that will be relevant to investigate in future, larger scale studies of HIV prevention efforts among people with alcohol use disorders.